This inspection was carried out over two days on the 27 and 30 September 2016. We gave the provider 48 hours’ notice of our visit on 27 September to make sure they or the registered manager was available to assist us with the inspection process and to provide us with access to records. On 30 September we conducted telephone calls to staff working for the agency and people using the services of the agency. The inspection team consisted of one adult social care inspector.

We last inspected A-Best Nursing and Care Limited on 23 April 2014. At that inspection we found the service was meeting the regulations we assessed.

At the time of our inspection there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

A-Best Nursing and Care Limited provides care and support to people living in their own homes.

Prior to our inspection we reviewed the information we held about the service. We reviewed the previous inspection report and the Provider Information Return (PIR) that the provider had completed March 2016. This is a document that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We also checked to see if the service had sent us any notifications in relation to significant events, including safeguarding and serious injury matters. None had been received since the last inspection had taken place in April 2014.

People were protected from harm and abuse due to the arrangements in place to make sure risks to people that used the service was reduced. Risk assessments had been completed and put in place to help people and staff to reduce and manage any known risks.

Staff had been appropriately recruited and there were sufficient staff at the time of this inspection to meet people’s individual needs. We found staff worked flexibly to respond to any changes in a person’s needs.

We saw records to indicate training that staff had completed and our conversations with the staff we spoke with confirmed this. People who used the service also told us they felt staff had the right abilities and skills to provide them with a service at a time that was right for them.

People using the service told us that the registered manager and provider regularly visited them at home to speak with them about their service, check records and carry out ‘spot checks’ on staffs delivery of their service.

We found that some information supplied to people such as the service user guide was incorrect and needed reviewing and updating in parts. The provider confirmed that this would be done.

Staff told us the registered manager and provider was approachable and listened to them. They also told us that they felt supported to carry out their job roles effectively and received verbal supervision on a regular basis.

No person using the service or staff spoken with raised any concerns about the service or its management.

Is the service safe?

People told us they were treated with respect and dignity by the staff. People told us they felt safe whilst their care was being provided. They said that staff understood how to safeguard the people who used the service.

Systems were in place to make sure managers and staff learned from events such as accidents and incidents, complaints, concerns, and whistleblowing. This reduced the risks to people and helped the service to continually improve.

We saw records to show that recruitment practice was safe and thorough. A range of policies and procedures were in place to make sure unsafe practice was identified and people were protected.

Is the service effective?

People's spoken with told us that their health and care needs were assessed with them. They told us they could express their views and felt they were always taken into account in the way the service was provided.

We saw that people’s mobility and equipment needs had been identified in the person’s care records where required.

A relative spoken with confirmed they were always welcomed by accommodating and supportive staff.

Is the service caring?

People spoken with told us they were supported by kind and helpful staff. People said, “They’re very good”, “They are very kind people” and “I’m very happy with them.”

People told us that the service regularly checked on the quality of the service they provided with people who used the service. Where shortfalls or concerns were raised these were addressed.

Is the service responsive?

People spoken with were aware of the complaints procedure but had never had cause to complain. They told us that they felt assured that complaints would be investigated and action taken as necessary.

Is the service well-led?

We saw records to show that the service worked well with other agencies and services to make sure people received the care they required.

The service had a quality assurance system. Records seen by us showed that the service had implemented the system and the response comments were positive. The manager told us that a spot check system ensured the quality and improvement of the service.